Editing Mood disorder (section)

=== Depressive disorders ===
* [[Major depressive disorder]] (MDD), commonly called major depression, unipolar depression, or clinical depression, wherein a person has one or more [[major depressive episode]]s. After a single episode, Major Depressive Disorder (single episode) would be diagnosed. After more than one episode, the diagnosis becomes Major Depressive Disorder (Recurrent). Depression without periods of mania is sometimes referred to as ''unipolar depression'' because the mood remains at the bottom "pole" and does not climb to the higher, [[mania|manic]] "pole" as in bipolar disorder.{{sfn|Parker|Hadzi-Pavlovic|Eyers|1996|p=173}}

:Individuals with a major depressive episode or major depressive disorder are at increased risk for [[suicide]]. [[Suicide prevention|Seeking help]] and treatment from a health professional dramatically reduces the individual's risk for suicide. Studies have demonstrated that asking if a depressed friend or family member has thought of committing suicide is an effective way of identifying those at risk, and it does not "plant" the idea or increase an individual's risk for suicide in any way.{{sfn|Sartorius|1993|p={{page needed|date=October 2021}}}} Epidemiological studies carried out in Europe suggest that, at this moment, roughly 8.5 percent of the world's population have a depressive disorder. No age group seems to be exempt from depression, and studies have found that depression appears in infants as young as 6 months old who have been separated from their mothers.<ref>{{cite journal | author = Ayuso-Mateos J.L.| year = 2001 | title = Depressive Disorders in Europe: Prevalence figures from the ODIN study | journal = British Journal of Psychiatry | volume = 179 | issue = 4| pages = 308–316 | doi=10.1192/bjp.179.4.308| pmid = 11581110 |display-authors=etal| doi-access = free }}</ref> However, there may be differences between cultures in prevalence of MDD due to cultural influences that "challenge the definition and diagnosis of psychiatric disorders", as seen in a study by Parker et al. that researched MDD in Chinese individuals.<ref>{{Cite journal |last=Parker |first=Gordon |last2=Gladstone |first2=Gemma |last3=Chee |first3=Kuan Tsee |date=June 2001 |title=Depression in the Planet’s Largest Ethnic Group: The Chinese |url=http://psychiatryonline.org/doi/abs/10.1176/appi.ajp.158.6.857 |journal=American Journal of Psychiatry |language=en |volume=158 |issue=6 |pages=857–864 |doi=10.1176/appi.ajp.158.6.857 |doi-access=free |url-status=live |archive-url=https://web.archive.org/web/20240703190756/https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.158.6.857?download=true |archive-date= Jul 3, 2024 }}</ref> [[Depressive Disorder Not Otherwise Specified|Depressive disorder]] (also known as [[Depression (mood)|depression]]) is a common mental disorder. It involves a depressed mood or loss of pleasure or interest in activities for long periods of time. Depression is different from regular mood changes and feelings about everyday life. It can affect all aspects of life. Depression can happen to anyone. People who have lived through abuse, severe losses, or other stressful events are more likely to develop depression.<ref>{{Cite web |title=Depressive disorder (depression) |url=https://www.who.int/news-room/fact-sheets/detail/depression |access-date=2024-03-11 |website=World Health Organization |date= 31 March 2023  |language=en}}</ref>
* Depressive disorder is frequent in primary care and general hospital practice but is often undetected.  Unrecognized depressive disorder may slow recovery and worsen prognosis in physical illness, therefore it is important that all doctors be able to recognize the condition, treat the less severe cases, and identify those requiring specialist care.<ref>Gelder & Mayou, Geddes (2005). Psychiatry: Page 170. New York, NY; Oxford University Press Inc.</ref>

: Diagnosticians recognize several subtypes or course specifiers:

:* ''[[Atypical depression]]'' (''AD'') is characterized by mood reactivity (paradoxical anhedonia) and positivity,{{Clarify | date = November 2019 | reason = What's the difference between mood reactivity and positivity?  "Mood reactivity" itself is explained in the Atypical depression article, but not "mood positivity."  Perhaps just drop the mood positivity and elaborate more on mood reactivity.}}  significant [[weight gain]] or increased appetite ("comfort eating"), excessive sleep or somnolence ([[hypersomnia]]), a sensation of heaviness in limbs known as leaden paralysis, and significant social impairment as a consequence of hypersensitivity to perceived [[social rejection|interpersonal rejection]].{{sfn|American Psychiatric Association|2000| pp=421–422}} Difficulties in measuring this subtype have led to questions of its validity and prevalence.{{sfn|Sadock|Sadock|2002| p=548}}

:* ''[[Melancholic depression]]'' is characterized by a loss of pleasure ([[anhedonia]]) in most or all activities, a failure of reactivity to pleasurable [[Stimulus (physiology)|stimuli]], a quality of depressed mood more pronounced than that of [[grief]] or loss, a worsening of symptoms in the morning hours, early-morning waking, [[psychomotor retardation]], excessive weight loss (not to be confused with [[anorexia nervosa]]), or excessive guilt.{{sfn|American Psychiatric Association|2000| pp=419–420}}

:* ''[[Psychotic major depression]]'' (''PMD''), or simply psychotic depression, is the term for a major depressive episode, in particular of melancholic nature, wherein the patient experiences psychotic symptoms such as [[delusion]]s or, less commonly, [[hallucination]]s. These are most commonly mood-congruent (content coincident with depressive themes).{{sfn|American Psychiatric Association|2000| p=412}}

:* ''[[Catatonic depression]]'' is a rare and severe form of major depression involving disturbances of motor behavior and other symptoms. Here, the person is mute and almost stuporous, and either is immobile or exhibits purposeless or even bizarre movements. Catatonic symptoms can also occur in [[schizophrenia]] or a [[manic episode]], or can be due to [[neuroleptic malignant syndrome]].{{sfn|American Psychiatric Association|2000| pp=417–418}}

:* ''[[Postpartum depression]]'' (''PPD'') is listed as a course specifier in DSM-IV-TR; it refers to the intense, sustained and sometimes disabling depression experienced by women after giving birth. Postpartum depression, which affects 10–15% of women, typically sets in within three months of [[childbirth|labor]], and lasts as long as three months.<ref>{{cite web |author=Ruta M Nonacs |url=http://www.emedicine.com/med/topic3408.htm |website=eMedicine |title=Postpartum Depression |archive-url=https://web.archive.org/web/20081013205912/http://www.emedicine.com/med/topic3408.htm |archive-date=13 October 2008 |url-status=dead}}</ref> It is quite common for women to experience a short-term feeling of tiredness and sadness in the first few weeks after giving birth; however, postpartum depression is different because it can cause significant hardship and impaired functioning at home, work, or school as well as, possibly, difficulty in relationships with family members, spouses, or friends, or even problems bonding with the newborn.<ref>O'Hara, Michael W. "Postpartum Depression: Causes and consequences." 1995.</ref> In the treatment of postpartum major depressive disorders and other unipolar depressions in women who are breastfeeding, [[nortriptyline]], [[paroxetine]] (Paxil), and [[sertraline]] (Zoloft) are in general considered to be the preferred medications.<ref>{{cite journal |volume=161 |issue=6 |title=Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants |vauthors=Weissman AM, Levy BT, Hartz AJ, Bentler S, Donohue M, Ellingrod VL, Wisner KL |journal=Am J Psychiatry |pages=1066–1078 |year=2004 |pmid=15169695 |doi=10.1176/appi.ajp.161.6.1066}}</ref> Women with personal or family histories of mood disorders are at particularly high risk of developing postpartum depression.<ref>Parry, Barbara L. "Premenstrual and Postpartum Mood Disorders." Volume 9.1. 1996. pp=11–16</ref>

:* ''[[Premenstrual dysphoric disorder]]'' (''PMDD'') is a severe and disabling form of [[premenstrual syndrome]] affecting 3–8% of menstruating women.<ref name=Rapkin/> The disorder consists of a "cluster of affective, behavioral and somatic symptoms" that recur monthly during the [[luteal phase]] of the [[menstrual cycle]].<ref name=Rapkin>{{cite journal |last1=Rapkin |first1=AJ |last2=Lewis |first2=EI |title=Treatment of premenstrual dysphoric disorder |journal=Women's Health |volume=9 |issue=6 |pages=537–56 |date= November 2013 |pmid=24161307 |doi=10.2217/whe.13.62|doi-access=free }}</ref> PMDD was added to the list of depressive disorders in the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' in 2013. The exact pathogenesis of the disorder is still unclear and is an active research topic. Treatment of PMDD relies largely on antidepressants that modulate serotonin levels in the brain via serotonin reuptake inhibitors as well as ovulation suppression using contraception.<ref name=Rapkin/>{{sfn|American Psychiatric Association|2013|pp=[https://archive.org/details/diagnosticstatis0005unse/page/171 171–175]}}

:* ''[[Seasonal affective disorder]]'' (''SAD''), also known as "winter depression" or "winter blues", is a specifier. Some people have a seasonal pattern, with depressive episodes coming on in the autumn or winter, and resolving in spring. The diagnosis is made if at least two episodes have occurred in colder months with none at other times over a two-year period or longer.{{sfn|American Psychiatric Association|2000| p=425}} It is commonly hypothesised that people who live at higher latitudes tend to have less sunlight exposure in the winter and therefore experience higher rates of SAD, but the epidemiological support for this proposition is not strong (and latitude is not the only determinant of the amount of sunlight reaching the eyes in winter). It is said that this disorder can be treated by [[light therapy]].<ref>{{Cite journal|last=Rosenthal|first=N.E|date=1984|title=A Description of the syndrome and preliminary findings with Light Therapy|journal=Archives of General Psychiatry|volume=41|issue=1|pages=72–80|doi=10.1001/archpsyc.1984.01790120076010|pmid=6581756|pmc=2686645}}</ref> SAD is also more prevalent in people who are younger and typically affects more females than males.<ref>{{cite journal |author1=Lam, Raymond W. |author2=Levitan, Robert D. | year = 2000 | title = Pathophysiology of seasonal affective disorder: a review | journal = Journal of Psychiatry and Neuroscience | volume = 25 | issue = 5| pages = 469–480 | pmid = 11109298 | pmc = 1408021 }}</ref>

:* ''[[Dysthymia]]'' is a condition related to unipolar depression, where the same physical and cognitive problems are evident, but they are not as severe and tend to last longer (usually at least 2 years).{{sfn|Schacter |Gilbert |Wegner |2011|pp=564–565}} The treatment of dysthymia is largely the same as for major depression, including antidepressant medications and psychotherapy.{{sfn|Sartorius|1993|p={{page needed|date=October 2021}}}}

:* ''[[Double depression]]'' can be defined as a fairly depressed mood (dysthymia) that lasts for at least two years and is punctuated by periods of major depression.{{sfn|Schacter |Gilbert |Wegner |2011|pp=564–565}}

:*[[Unspecified depressive disorder|Unspecified Depressive Disorder]] is designated by the [[DSM-IV Codes|code]] ''311'' for depressive disorders. In the DSM-5, Unspecified Depressive Disorder encompasses symptoms that are characteristic of depressive disorders and cause significant impairment in functioning, but do not meet the criteria for the diagnosis of any specified depressive disorders. In the DSM-IV, this was called Depressive Disorder Not Otherwise Specified.

:*''[[Depressive personality disorder]]'' (DPD) is a controversial psychiatric diagnosis that denotes a personality disorder with depressive features. Originally included in the DSM-II, depressive personality disorder was removed from the DSM-III and DSM-III-R.<ref>{{cite web |last=Millon |first=T. |date=2006 |title=Personality subtypes |publisher=Institute for Advanced Studies in Personology and Psychopathology |url=http://millon.net/taxonomy/summary.htm |access-date=1 November 2010 |url-status=dead |archive-url=https://web.archive.org/web/20131023055645/http://millon.net/taxonomy/summary.htm |archive-date=23 October 2013}}</ref> Recently, it has been reconsidered for reinstatement as a diagnosis. Depressive personality disorder is currently described in Appendix B in the DSM-IV-TR as worthy of further study.

:* ''[[Recurrent brief depression]]'' (''RBD''), distinguished from major depressive disorder primarily by differences in duration. People with RBD have depressive episodes about once per month, with individual episodes lasting less than two weeks and typically less than 2–3 days. Diagnosis of RBD requires that the episodes occur over the span of at least one year and, in female patients, independently of the [[menstrual cycle]].{{sfn|American Psychiatric Association|2000| p=778}} People with clinical depression can develop RBD, and vice versa and both illnesses have similar risks.<ref>{{cite journal |author1=Carta, Mauro Giovanni |author2=Altamura, Alberto Carlo |author3=Hardoy, Maria Carolina |year=2003|title=Is recurrent brief depression an expression of mood spectrum disorders in young people? |journal=European Archives of Psychiatry and Clinical Neuroscience |volume=253 |issue=3 |pages=149–53 |doi=10.1007/s00406-003-0418-5 |pmid=12904979 |display-authors=etal|hdl=2434/521599 |s2cid=26860606 |hdl-access=free}}</ref>{{Clarify |date=November 2019 |reason=What kind of risks?  The second statement (from and both...) cannot be verified against the source.}}

:* ''[[Minor Depressive Disorder|Minor depressive disorder]]'', or simply minor depression, which refers to a depression that does not meet full criteria for major depression but in which at least two symptoms are present for two weeks.<ref>{{cite journal |vauthors=Rapaport MH, Judd LL, Schettler PJ, Yonkers KA, Thase ME, Kupfer DJ, Frank E, Plewes JM, Tollefson GD, Rush AJ |year=2002|title=A descriptive analysis of minor depression |journal=American Journal of Psychiatry |volume=159 |issue=4 |pages=637–43 |pmid=11925303 |doi=10.1176/appi.ajp.159.4.637 }}</ref>